Effect of dopamine agonist medication on prolactin producing pituitary adenomas

Conventional light microscopy, immunocyto-chemistry, electron microscopy and in situ hybridization were used to evaluate the effect of dopamine agonists (bromocriptine-LAR and bromocriptine) on the morphology of surgically removed prolactin (PRL)-producing pituitary adenomas. Dopamine agonist therapy resulted in decrease of serum PRL, clinical improvement and tumour shrinkage. Using light and electron microscopy cellular atrophy, interstitial and perivascular fibrosis were noted; in several tumours connective tissue accumulation was pronounced. The cellular response was not uniform. In some adenomas populations of large cells and small cells were distinguished. The large cells contained immunoreactive PRL and expressed the PRL gene indicating resistance to dopamine agonists. It appears that these cells retained the potential to secrete PRL and proliferate despite exposure to dopamine agonists. In the small cells, PRL immunoreactivity and PRL gene expression decreased providing evidence that both PRL release and synthesis were blocked. Small cells can persist in tumours after discontinuation of dopamine agonist medication suggesting these small cells are irreversibly suppressed and are not capable of regaining their endocrine function and proliferative capability. The formation of irreversibly suppressed PRL cells may explain why some PRL-producing adenomas do not recur after withdrawal of dopamine agonists.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47517/1/428_2005_Article_BF01605931.pd

Characteristics of the arthropathy described in hereditary haemochromatosis

Hereditary Haemochromatosis is a common inherited disorder, which primarily affects populations of northern European origin. Individuals homozygous for the C282Y mutation in the HFE gene product have up to a 30 percent chance of developing significant disease as a result of iron overload. Arthropathy is arguably the most disabling complication of iron overload in this disorder. Here we review the clinical and pathophysiological aspects of arthropathy in Hereditary Haemochromatosis

Baseline indices of iron load predict severity of arthropathy in C282Y homozygous HFE haemochromatosis

Objective: To determine the relationship between baseline indices of iron load and severity of arthropathy in C282Y homozygous HFE haemochromatosis (HH). Method: Genetically proven HH participants from a previous community-based study who had clinical and radiologically confirmed arthropathy compatible with HH were included. The most recent joint imaging and blood tests available up to November 2021 were used to assess the summative joint damage score (SJDS), which comprises the sum of radiological grades in all clinically affected joints and all joints in the hands. Relevant x-rays were examined by both a rheumatologist and musculoskeletal radiologist. Joint scores were assigned in keeping with published systems of classification. Discrepancies were resolved by consensus. Results: Nineteen participants with HH and arthropathy (median age 55 years) were analysed. Statistically significant correlations were observed between SJDS and serum ferritin at diagnosis of HH and between SJDS and the red cell mean corpuscular volume (MCV) at diagnosis of HH, [r = 0.58, p = 0.01 and r = 0.474, p = 0.04, respectively]. There was no statistically significant correlation between transferrin saturation at diagnosis and SJDS. Neither current ferritin nor current transferrin saturation were found to correlate with SJDS. Conclusion: Indices of iron metabolism at the time of HH diagnosis and, in particular, serum ferritin concentrations and elevation of the MCV were found to be associated with the radiological severity of HH arthropathy. This finding suggests that baseline iron load is a prognostic marker for joint disease severity and that ferritin concentration at diagnosis is likely to be mechanistically important in the development of chondral damage

The existence of cords in olecranon bursae.

The purpose of this study was to document the existence of transverse cords in olecranon bursae in patients undergoing excision of the bursa and to describe the unique clinical presentation of patients with these cords. A retrospective study was performed on 24 patients who had surgery to excise an olecranon bursa between 2006 and 2011. The patient's history, preoperative radiographs, ultrasound images, intraoperative photographs, and findings on histologic analysis were reviewed in all cases. Nine olecranon bursae had cords (cord group) and 15 did not have cords (noncord group). All patients in the cord group were male manual laborers, and nearly all had olecranon enthesophytes (n?=?8). Patients in the noncord group had associated medical conditions or an infection. A higher level of satisfaction was reported in the noncord group after surgical excision. This study documents the existence of transverse cords oriented at right angles to the long axis of the olecranon. Olecranon bursae with cords have a unique presentation and are found in male manual workers, are nearly always associated with an olecranon enthesophyte, and do not present with infections